Provider Demographics
NPI:1922883669
Name:MARGIE BRUBAKER LLC
Entity Type:Organization
Organization Name:MARGIE BRUBAKER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEMBKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-620-8700
Mailing Address - Street 1:PO BOX 4007
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-4007
Mailing Address - Country:US
Mailing Address - Phone:301-620-8700
Mailing Address - Fax:
Practice Address - Street 1:111 COUNCIL ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5412
Practice Address - Country:US
Practice Address - Phone:301-620-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health